Health

Can’t Breathe When Asleep? What You Need To Know about Sleep Apnea

Published

4 years ago

January 22, 2021

Restlessness during sleep or waking up multiple times at night could be a sign of an underlying serious sleep disorder. If you find yourself tired even after a full night’s sleep or if your partner complains about your loud snoring while you are asleep, then this could be due to sleep apnea.

Sleep apnea is a potentially life-threatening health condition where a person suddenly stops breathing for a few seconds during sleep. It is important to have yourself evaluated by a sleep apnea specialist if you suffer such symptoms and this is more often noticed by your sleep partner. Obstructive sleep apnea (OSA) increases the risk of high blood pressure while also putting you at risk of heart attacks, arrhythmias (irregular heartbeats), stroke and other cardiovascular diseases.

What is sleep apnea?

Sleep apnea is a disorder caused by collapse or closure of your airway where breathing is repeatedly interrupted during sleep. This interruption can occur from anywhere between 5 to over 100 times in an hour! The pauses in breathing can last between 10 to 20 seconds, and sometimes as long as more than a minute. During sleep apnea, when you stop breathing, no oxygen enters the lungs, causing a drop in the level of oxygen in the blood. This leads to reduced blood oxygen supply to your brain, heart and other vital organs.

Sleep becomes disturbed in patients with sleep apnea which means that they do not get the deep restorative sleep which is needed for mental alertness and clear memory for a productive next day. Abnormal sleep patterns arise, consisting of frequent long pauses in breathing where the patient suddenly goes silent for a while, followed by a sudden loud gasping, choking or snorting episode when they start to breathe again. This becomes a vicious cycle night after night for prolonged periods, sometimes many years before the patient finally decides to seek medical help for his sleep problems. Sleep apnea needs medical intervention as it leads to many health problems and could even be fatal, leading to sudden death during one’s sleep. A person with the condition may not be aware, but anyone sleeping beside him or her can easily recognise the worrying symptoms of sleep apnea. If your partner suspects you are a victim of sleep apnea, then you should consult an ENT specialist without delay.

What are the types of sleep apnea?

The most common is obstructive sleep apnea (OSA). During this condition, the inflow and outflow of air from the nose is blocked due to throat muscles relaxing and collapsing inwards while sleeping. This will result in loud snoring with recurrent pauses in breathing, night-time waking and gasping or snorting episodes. Another condition is central sleep apnea where the central nervous system is involved. In central sleep apnea, the brain temporarily stops signalling the muscles responsible for breathing to continue. Some patients may suffer from mixed sleep apnea which is a rare combination of both central and obstructive sleep apnea.

What are the causes of sleep apnea?

There could be many reasons for obstructive sleep apnea. Individuals who are overweight tend to have excess fatty tissue deposited just outside the throat. This causes the pressure on the inside of the throat to increase, especially when lying flat during sleep, causing the airway to collapse and close off. In addition, throat muscles can relax even further due to alcohol or medication use prior to sleep, worsening the airway obstruction. Presence of nasal obstruction from nasal allergies or deviated nasal septum, or enlarged tonsils or jaw deformities may also obstruct the airway. Asthma patients and smokers have a higher chance of sleep apnea. This condition is more common in males than women and it increases with age, although this condition may occur at any age.

What are the symptoms of obstructive sleep apnea?

The initial signs are complaints by your partner of loud snoring. Other signs to look out for include:

Headaches in the morning
Fatigue and tiredness throughout the day
Memory loss
Difficulty focusing or concentrating on the task at hand
Sore throat
Dry mouth
Mood and behavioural changes like irritability and bad temper

What are the health problems associated with obstructive sleep apnea?

In addition to impacting your quality of life, this condition can lead to the following health problems:

Hypertension (high blood pressure)
Heart attacks
Stroke
Depression
Dementia
Type II Diabetes
Irregular heartbeat (arrhythmias)

Early treatment can minimise the risk of developing heart attacks and strokes as complications of untreated sleep apnea.

How is obstructive sleep apnea diagnosed?

As there are many reasons why an individual might have sleep disturbances, it is not always easy for your family doctor to suspect that you have sleep apnea. A referral is usually made to an ENT doctor to examine the airway for signs of nose or throat narrowing. Taking your sleep partner along can be helpful as he or she will be able to give an insight on your breathing pattern while asleep and snoring episodes.

Your ENT sleep specialist will take a detailed medical history and perform a physical examination of your nose and throat. Your blood pressure and Body Mass Index (BMI) may also be checked. Additional tests like sleep studies may be needed to confirm the diagnosis.

Polysomnography is a sleep study where your heart, lung and brain activity patterns are measured and oxygen levels monitored while you sleep. Nowadays, most patients usually undergo a home sleep study with a portable device. This used to be done as a hospital-warded procedure where you might have to have yourself monitored all night but a home sleep study can now reliably provide enough good quality sleep data to accurately diagnose and detect sleep apnea.

What is the treatment for obstructive sleep apnea?

First and foremost, your ENT doctor will advise on lifestyle modifications. These include losing weight if you are obese, through a diet and regular exercise regimen. Avoiding alcohol and smoking especially prior to bedtime is strongly recommended. Nasal sprays and antihistamines may be prescribed if you have a blocked nose. If sleep apnea persists even after these measures, then personalised treatment measures will be considered to keep the airways open, with a thorough discussion about CPAP, surgery or a special mouthguard.

In CPAP or continuous positive airway pressure, a special machine delivers pressurised air through the nose and mouth via a fitted mask while the individual is sleeping. These devices help to keep the upper airway passages open while air is continuously pumped in. This prevents the symptoms of snoring and sleep apnea. This is the most widely used method to treat obstructive sleep apnea, but it may not suit everyone. Some people find it uncomfortable and may not attain the right fit. It is important to try different nasal or face masks to find the right fit. Talk to your ENT doctor to check on what suits you the best.

Alternatives to CPAP machines are oral devices or mouthpieces which help to keep the throat open during mild to moderate conditions. Some devices hold the tongue in a different position. Nasal pillow masks are another option if you feel claustrophobic in masks that cover the entire face. Close follow-up helps to achieve successful treatment in patients with obstructive sleep apnea.

If none of these conservative methods work, then your sleep apnea specialist will suggest surgery where excess throat tissue will be removed in a procedure called Uvulopalatopharyngoplasty (UPPP). For very severe cases, upper airway stimulation is another method where an impulse generator detects breathing patterns and controls tongue movement but this is rarely used in clinical practice.

There are many treatment options for obstructive sleep apnea. What is important is to meet an experienced ENT physician without delay and discuss a treatment plan if you are diagnosed with sleep apnea. Dr. Annabelle Leong specialises in treating sleep apnea in Singapore and is a great ENT doctor to visit if you are suffering from sleep apnea.

Health

Inside Dr. James Lee’s Surgical Suite: A Look at Gynecomastia Correction

Published

2 weeks ago

September 30, 2024

Michelle Langton

Photo Credit: Dr. James Lee Cosmetic Surgery Clinic

Byline: Katreen David

“Cosmetic surgery is no longer about extremes; it’s about harmonizing your outer self with the person you’ve always known yourself to be,” says Dr. James Lee, reflecting on the industry’s evolving standards for both men and women. “In recent years, we’ve seen a gravitation toward subtle enhancements that speak to individual authenticity rather than transformation for the sake of it.”

Procedures such as gynecomastia correction are a barometer of the times. It captures society’s dynamic views on beauty, self-expression, and, increasingly, the desire for authenticity.

Gynecomastia correction is a procedure designed to address the excessive development of male breast tissue, a condition that can cause emotional distress and a deep sense of self-consciousness for many men. Gynecomastia is more than a cosmetic issue. It stems from various causes—hormonal imbalances, obesity, genetics, or even the side effects of medication. For numerous men, surgery is the final step after years of struggle with their body image.

“I’ve had patients tell me they haven’t been to the beach in years or that they wear multiple layers of clothing just to feel comfortable,” Dr. Lee explains. “It’s not just about how they look, but how they feel about themselves.”

The surgical suite of Dr. James Lee, a leading figure in the plastic surgery industry, makes ripples in this respect. His practice is a safe space where progressive techniques meet state-of-the-art technology, offering clients subtle amplifications that make them feel secure, comfortable, and welcome in his practice.

Precision Meets Compassion in the Operating Room

For Dr. Lee, each gynecomastia surgery is a blend of art and science, involving the removal of excess fat, glandular tissue, and, in some cases, skin. He uses a combination of liposuction and excision techniques, depending on the patient’s needs. Small incisions are carefully placed in inconspicuous areas, often around the nipple or lateral chest, to minimize scarring.

“The goal is to restore a natural, masculine contour to the chest while minimizing any visible signs of surgery,” says Dr. Lee. His steady hands reflect years of experience and dedication to delivering results that are both physically transformative and emotionally freeing.

Patients, typically, undergo the procedure under local anesthesia with sedation, though some opt for general anesthesia. The operation itself may take a couple of hours, but the impact on the patient’s life can be immeasurable.

It is worth noting that, in Dr. Lee’s practice, the procedure doesn’t end in the operating room. Instead, it is the beginning of a recovery process designed to render the best possible results.

“We take the time to walk patients through every step of recovery,” he says. “From wearing compression garments to controlling swelling, everything is about ensuring the final result meets their expectations.”

Patients leave the clinic the same day, albeit with detailed post-operative instructions that extend beyond healing. For Dr. Lee, success is measured by physical results, the patients’ trust in him, and their satisfaction with their newfound confidence as they recover and return to their daily lives.

The Psychological Toll of Gynecomastia

Gynecomastia affects more than just the physical appearance. A multitude of men experience a profound impact on their self-esteem and mental well-being. As Dr. Lee notes, “Some men live with this condition for years, feeling trapped in their bodies and avoiding social activities, sports, or even intimacy because of how they feel about their chest.”

In a society where male body image issues are often overlooked, Dr. Lee’s practice is a safe space where men can openly discuss their struggles. He frequently hears stories from patients who have been ridiculed or who have suffered in silence, feeling isolated because of a condition that is rarely talked about.

However, once they have the surgery, the change in their demeanor is almost immediate. “It’s like watching a weight being lifted off their shoulders,” says Dr. Lee. “They carry themselves differently, with more confidence. It’s not just a physical transformation; it’s an emotional one as well.”

Dr. Lee understands the sensitivity surrounding gynecomastia correction and has tailored his approach to meet both the physical and emotional needs of his patients. Each consultation is an opportunity for him to listen and guide his patients through the decision-making process, ensuring they have realistic expectations and understand the nuances of the surgery.

Dr. Lee’s reputation for gynecomastia correction has earned him praise in the medical community and gratitude from countless patients. As body image issues among men continue to gain recognition, his work shines a light on the importance of offering solutions that go beyond the surface.

Beauty Rewired: High-Tech, Heartfelt Transformations

One of the hallmarks of Dr. James Lee’s practice is his meticulous work in the operating room and the exceptional team providing outstanding service by his side.

Dr. Lee is acutely aware of the importance of balancing technology with the indispensable human touch. “Technology is an incredible tool, but it’s not a replacement for the surgeon’s proficiency and intuition. My job is to guide my patients and help them understand what’s possible and realistic,” he says. His mantra resonates with a growing demographic of patients seeking reassurance and innovation in equal measure.

The Road Ahead: Ethical and Aesthetic Considerations

As the industry evolves, ethical considerations are increasingly coming to the forefront. The rise of social media has fueled unrealistic beauty standards, leading to an uptick in procedures among younger demographics. This has prompted a debate within the industry about the role of cosmetic surgery in perpetuating certain ideals.

“We have a responsibility as surgeons to ensure that our work doesn’t contribute to a culture of unattainable beauty,” Dr. James Lee emphasizes. “We have to focus on enhancing what’s already there, not creating something that isn’t. Patients should feel empowered, not pressured, by the available options.”

Top-tier surgeons are increasingly adopting this ethical stance as they recognize the impact of their work on both individual lives and vast societal standards.

Where Beauty Meets Brains: Crafting Aesthetic Integrity in the Modern Age

As we move further into 2024, it’s clear that the field of cosmetic surgery is undergoing a significant transformation—one that prioritizes authenticity, patient well-being, and ethical responsibility.

Dr. James Lee is one of the forward-thinking minds propelling this movement to new heights. He effectively leads the way with innovative techniques and a commitment to natural, individualized results. “The future of cosmetic surgery isn’t about keeping up with trends; it’s about understanding what makes each person unique and enhancing that essence,” he concludes.

Responding to the critics who typecast the beauty industry as a superficial field, Dr. James Lee’s plastic surgery clinic offers a refreshing perspective. It values subtlety over spectacle and integrity over imitation. This is the essence of gynecomastia correction and every other careful procedure that Dr. Janes Lee performs.

As the demand for these kinds of results grows, so does the importance of practitioners who can deliver them with skill and sensitivity. Dr. James Lee’s practice is a game-changer in this new era, where technology and artistry meet to create something truly remarkable: your most authentic version.